acute pericarditis - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 01-01-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 11
Threads: 3
Thanked 0 Times in 0 Posts
Reputation: 10
Default acute pericarditis

how does a/c pericarditis chest pain relieved by sitting and leaning forward???
Reply With Quote Quick reply to this message



  #2  
Old 01-01-2013
USMLE Forums Guru
 
Steps History: Not yet
Posts: 375
Threads: 17
Thanked 131 Times in 81 Posts
Reputation: 147
Default

As far my understanding of this concept is that when you lean forward, there is a gap between the pericardium and chest wall.which relieves the pain.
Otherwise the already inflamed pericardium will rub against the chest wall, causing pain.

Please correct me if I am wrong.
Reply With Quote Quick reply to this message
  #3  
Old 01-01-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 11
Threads: 3
Thanked 0 Times in 0 Posts
Reputation: 10
Default

i hv been looking for an answer online but cudnt find it... all i cud think of is dat on leaning or sitting up, VR wud increase .. but i cudnt make any sense of it.
Reply With Quote Quick reply to this message
  #4  
Old 01-02-2013
USMLE Forums Newbie
 
Steps History: ---
Posts: 2
Threads: 0
Thanked 1 Time in 1 Post
Reputation: 11
Default

Ok, first off I just want to say that I am not studying to become a physician, or specialist (studying to become a nurse anesthetist) but I do a lot of studying outside of school because I love this stuff so here's my take on the situation since I can kinda relate - diagnosed with cardiac tamponade two summers ago which presents with very similar symptoms to acute pericarditis ...

Anyways, I remember having a very hard time breathing while laying down but it was relieved by sitting up. Sitting forward? Sorta the same thing I guess, I never thought about it but I know leaning forward can help with COPD (more specifically emphysema pts.) who are struggling to breathe:/ But sitting up helps in cardiac tamponade because it allowed the fluid to kinda settle, but laying down caused the fluid to spread out (if that makes sense!) making the pumping of the heart more difficult... but that is what my G.I. doctor told me (the fluid around my heart was "believed" to be due to a medication prescribed for my ulcerative colitis). And although acute pericarditis is not the same as cardiac tamponade, pericarditis can lead to cardiac tamponade (sometimes) and if there is fluid starting to form in that tight space then this is going to cause a sort of smothering of the heart (I also had a nonproductive cough, feeling like I had to cough but not for any reason) and sometimes bloody foam would come up because the coughing would lead to vomitus (perhaps the heart is sort of drowning in the fluid causing you to want to cough to remove it???!?)

Anyways, this is only my take on it but if anyone has any other thoughts it would be greatly appreciated!
Reply With Quote Quick reply to this message
The above post was thanked by:
preetk (01-03-2013)
  #5  
Old 01-02-2013
podebrad's Avatar
USMLE Forums Addict
 
Steps History: CK+CS
Posts: 138
Threads: 28
Thanked 77 Times in 36 Posts
Reputation: 87
Smile

Quote:
Originally Posted by preetk View Post
how does a/c pericarditis chest pain relieved by sitting and leaning forward???
The sharp chest pain associated with pericarditis occurs when the inflamed or irritated layers of the pericardium rub against each other. When you lean forward, the parietal and visceral layers are far apart and have less chance of rubbing against each other as opposed to when they are on bed. Thus there is a change in pain with positional change.

Hope it helps.
Reply With Quote Quick reply to this message
The above post was thanked by:
nandish_m (01-04-2013), preetk (01-03-2013), satrun (09-14-2016)
  #6  
Old 01-03-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 11
Threads: 3
Thanked 0 Times in 0 Posts
Reputation: 10
Default

@futurena..
thanks for t reply... it does make sense... but u now how one explanation gives rise to another question...so i get it that while leaning forward or sitting t fluid settles down n thus d pt does not feel d pain...i guess thats wat u r tryin to say ( which does make sense) but then d same amt of fluid is still der in bet t two layers rite... (prob min of 100 ml) so it settles down means it prob moves to d bottom of t pericardial space... am i rite??? but its still d same amt there... so it doesnt coz anymore prob... ??
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Acute Cholecystitis Vs Acute Ascending Cholangitis Hohepa USMLE Step 2 CK Forum 2 01-28-2015 05:28 AM
Steroid use in pericarditis Dr. N Elham USMLE Step 2 CK Forum 6 03-27-2013 09:45 PM
CCS Pericarditis DRFP USMLE Step 3 Forum 3 08-22-2012 06:45 AM
hemorraghic pericarditis menatallah Elgohary USMLE Step 1 Forum 6 11-13-2011 07:06 PM
Acute pericarditis with mild effusion--what's the next step? kemoo USMLE Step 2 CK Forum 15 07-05-2011 04:35 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)